Technical Note: Correction for the effect of breathing variations in CT pulmonary ventilation imaging

The accuracy and precision of computed tomography (CT) pulmonary ventilation imaging with conventional CT scanners are limited by breathing variations. We propose a method to correct for the effect of breathing variations in CT ventilation imaging based on external respiratory signals acquired throughout a scan.

The proposed method is based on: (a) calculating voxel-by-voxel abdominal surface motion ranges using four-dimensional (4D) CT image datasets spatiotemporally correlated with external respiratory monitor data, and (b) applying the correction factor, which is defined as the ratio of the overall mean of the abdominal surface motion range in the lungs to that of each voxel, to the CT ventilation value. The performance of the proposed method was investigated by comparing voxel-wise correlations of the uncorrected and corrected CT ventilation images with single-photon emission CT (SPECT) ventilation images as a ground truth for nine patients. CT ventilation images were calculated by deformable image registration of the 4D-CT image datasets, followed by calculation of regional volume changes. A Steiger's Z-test was used to determine the statistical significance of the difference between the correlations for the uncorrected and corrected CT ventilation images.

The proposed correction method resulted in significant increases (P < 0.05) in the correlation between CT and SPECT ventilation in three patients, trends toward significant increase (P: 0.13-0.18) in two patients, no significant differences in three patients, and a significantly decreased correlation in one patient. The average standard deviation of the abdominal surface motion range in three patients showing significant increases was 0.27 (range 0.10-0.37), which was greater than 0.17 (range 0.07-0.38) in the other six patients.

The proposed method to correct for the effect of breathing variations could be readily implemented and has the potential to improve the accuracy of CT ventilation imaging as demonstrated in a nine-patient study.